Feeling your heart race, pound, flutter or skip a beat can be unsettling during pregnancy. In many cases the explanation is harmless, but persistent or concerning symptoms deserve medical evaluation.
Heart palpitations are common during pregnancy. Normal pregnancy increases heart rate, blood volume and the amount of blood the heart pumps, and premature atrial or ventricular beats can also become more noticeable. However, palpitations may sometimes be associated with anemia, thyroid problems, dehydration, infection, electrolyte abnormalities or a genuine heart rhythm disorder. New, recurrent or troublesome palpitations should therefore be discussed with your pregnancy care team rather than automatically assumed to be harmless.
Why Can Heart Palpitations Happen During Pregnancy?
A palpitation is the sensation of being unusually aware of your heartbeat. You may describe it as racing, pounding, fluttering, skipping or an extra beat. Palpitations are a symptom rather than a diagnosis, and they do not necessarily mean that an abnormal heart rhythm is present.
Pregnancy produces major cardiovascular changes. Your blood volume increases, your heart pumps more blood each minute, and your resting heart rate commonly rises. Hormonal and autonomic nervous-system changes also occur. Together, these changes can make your heartbeat more noticeable and can increase the occurrence of premature beats in some people.
That is why many episodes are ultimately found to represent normal sinus rhythm, a somewhat faster normal heart rate, premature atrial contractions (PACs), or premature ventricular contractions (PVCs). You can read more about the difference between sensations and possible rhythm problems in our guide to heart palpitation symptoms.
Common Causes of Heart Palpitations During Pregnancy
1. Normal cardiovascular changes
Pregnancy increases circulating blood volume, cardiac output and heart rate. A faster or stronger heartbeat can therefore become easier to notice, especially during activity, when lying quietly or later in pregnancy.
2. Premature beats
PACs and PVCs are extra beats arising from the upper or lower chambers of the heart. They may feel like a skipped beat, pause, thump or flutter. Isolated premature beats are common and are often benign when the heart is otherwise healthy.
3. Anemia or iron deficiency
Pregnancy increases iron requirements. Significant anemia can make the heart beat faster and may contribute to palpitations, fatigue, weakness or shortness of breath. A complete blood count is commonly used when anemia is suspected.
4. Thyroid problems
Thyroid dysfunction, particularly excessive thyroid hormone activity, can cause a rapid or forceful heartbeat and sometimes an abnormal rhythm. Learn more about thyroid problems and heart palpitations.
5. Dehydration, illness or metabolic changes
Vomiting, inadequate fluid intake, fever, infection or significant electrolyte disturbances can increase heart rate or contribute to ectopic beats. Persistent vomiting during pregnancy deserves medical assessment because dehydration and electrolyte abnormalities can become significant.
6. Stress, anxiety and poor sleep
Stress hormones can increase heart rate and make normal heartbeat sensations easier to notice. Anxiety can therefore contribute to palpitations, but recurrent symptoms should not automatically be attributed to anxiety without considering medical causes.
7. Caffeine and other stimulants
Caffeine can make palpitations more noticeable in sensitive individuals. During pregnancy, total caffeine intake is generally advised to remain below about 200 mg per day. Someone whose symptoms clearly occur after caffeine may find that an even lower intake helps.
8. A heart rhythm disorder
Less commonly, symptoms may be caused by supraventricular tachycardia (SVT), atrial fibrillation or another arrhythmia. Pregnancy can also make a pre-existing arrhythmia more symptomatic. This is one reason recurrent or sustained episodes deserve proper rhythm documentation.
Other medicines, stimulants and medical conditions can also contribute. See our broader guide to the causes and triggers of heart palpitations for additional possibilities.
How Common Are Palpitations During Pregnancy?
Palpitations are frequently reported during pregnancy, but there is no reliable figure showing that a particular percentage of all pregnant women will experience them.
Research and expert guidance show that sinus tachycardia and premature atrial or ventricular beats are common findings among pregnant patients evaluated for palpitations. Importantly, the sensation of palpitations does not always correspond to an abnormal rhythm when the heartbeat is recorded.
How Are Heart Palpitations Evaluated During Pregnancy?
Current expert guidance recommends that pregnant patients presenting with palpitations receive an appropriate initial assessment rather than having the symptoms dismissed simply because they are pregnant.
Your doctor may ask about
- when the episodes began;
- how long they last;
- whether the heartbeat feels regular or irregular;
- how suddenly the episode begins and ends;
- whether symptoms happen during rest, exercise, meals or stress;
- caffeine, medicines and stimulant use;
- associated dizziness, fainting, chest discomfort or breathlessness;
- previous heart disease or arrhythmias; and
- relevant family history, including unexplained sudden cardiac death.
ECG
A resting 12-lead electrocardiogram (ECG) is part of the standard initial evaluation for new cardiac symptoms or suspected arrhythmia during pregnancy. It is noninvasive and does not expose the fetus to ionizing radiation.
However, a normal ECG obtained between episodes does not completely exclude an intermittent arrhythmia.
Blood tests
Depending on the circumstances, targeted blood tests may be used to look for conditions such as anemia, thyroid dysfunction, infection or electrolyte abnormalities.
Holter, patch or event monitoring
If palpitations are intermittent, ambulatory ECG monitoring can record the rhythm over a longer period. A Holter monitor, patch monitor or event recorder may therefore be more useful than a brief office ECG for establishing a symptom-rhythm correlation.
Current European guidance advises a relatively low threshold for longer-term rhythm monitoring when pregnant patients present with palpitations or syncope.
Echocardiogram
An echocardiogram may be appropriate when there is concern about structural heart disease, an abnormal examination or ECG, significant arrhythmia, or other cardiovascular findings. Standard transthoracic echocardiography is the first-line cardiac imaging technique during pregnancy.
What Can You Do About Palpitations During Pregnancy?
Management depends on what is causing the symptoms. If the evaluation is reassuring and the episodes represent modest sinus tachycardia or isolated premature beats, specific medical treatment may not be necessary.
Practical measures may include
- maintaining adequate hydration unless your clinician has given you a fluid restriction;
- eating regularly, especially if nausea or reduced food intake has been a problem;
- getting adequate rest and sleep;
- reducing excessive caffeine and other stimulants;
- avoiding smoking and recreational drugs;
- using safe relaxation techniques when stress contributes to symptoms; and
- keeping a symptom record showing the time, duration, activity and approximate heart rate during episodes.
During pregnancy, caffeine intake is generally kept below about 200 mg per day from all sources. This is an upper limit rather than a target. If coffee, tea, energy drinks or other caffeinated products consistently trigger your palpitations, reducing the amount further may be reasonable.
What about the Valsalva maneuver?
Vagal maneuvers such as a modified Valsalva maneuver can be useful for certain regular supraventricular tachycardias in a medically stable patient. They are not a routine treatment for every episode of undiagnosed pregnancy palpitations.
If you have previously been diagnosed with SVT, your cardiology or pregnancy care team can explain what you should do if another episode occurs. Do not repeatedly perform forceful maneuvers for unexplained symptoms without knowing what rhythm is present.
What if a medical condition is responsible?
Treatment is directed at the underlying diagnosis. For example, a clinician may need to address significant anemia, thyroid disease, infection or another medical cause. Documented arrhythmias are managed according to the rhythm, severity of symptoms, stage of pregnancy and overall cardiovascular health.
Several cardiac treatments can be used during pregnancy when clinically necessary, but the choice of medication or procedure requires individualized consideration of both maternal and fetal risks and benefits.
Dr. Albana’s Note
When a pregnant patient tells me that her heart suddenly feels as if it is racing or skipping, I first try to understand exactly what she feels, how long it lasts and whether dizziness, chest discomfort, fainting or shortness of breath occurs with it. Pregnancy itself can make the heartbeat faster and more noticeable, but I would not assume that every palpitation is simply “because of pregnancy.” A basic assessment can often separate a reassuring pattern from symptoms that need rhythm monitoring or further investigation.
When Should You Contact Your Doctor?
Arrange medical assessment if your palpitations are new, recurrent, worsening or troublesome, particularly if they:
- occur repeatedly or become more frequent;
- last longer than brief isolated beats;
- produce a persistently rapid or irregular heartbeat;
- occur during exercise;
- are associated with unusual fatigue or weakness;
- occur with recurrent dizziness;
- begin after starting or changing a medicine;
- occur in someone with known heart disease or a previous arrhythmia; or
- feel substantially different from previous pregnancy symptoms.
Dizziness occurring with palpitations deserves particular attention. See dizziness and heart palpitations for additional information.
Urgent Warning Signs During Pregnancy
Seek urgent or emergency medical assessment rather than continuing to read online if palpitations occur with:
- chest pain, significant pressure or tightness;
- fainting or loss of consciousness;
- collapse;
- severe shortness of breath or difficulty speaking because you cannot catch your breath;
- severe dizziness or a feeling that you may pass out;
- a sustained very rapid or markedly irregular heartbeat together with feeling seriously unwell;
- sudden breathing difficulty accompanied by pain or swelling in one leg; or
- rapidly worsening cardiovascular symptoms.
Chest symptoms combined with palpitations require particular caution. Read our chest pain and palpitations guide, but obtain urgent medical care first when significant chest pain or other emergency symptoms are present.
Most Asked Questions
Are heart palpitations normal during pregnancy?
They are common, and many are related to normal pregnancy physiology, sinus tachycardia or isolated premature beats. However, “common” does not mean that every episode should automatically be considered normal. Recurrent, sustained or symptomatic palpitations should be discussed with your healthcare professional.
Can pregnancy make my heart beat faster?
Yes. Pregnancy normally increases heart rate and cardiac output as the cardiovascular system adapts to the needs of the pregnant person and developing fetus. This can make the heartbeat more noticeable.
Can anemia cause palpitations during pregnancy?
Yes. Significant anemia can cause a faster heartbeat and may occur with fatigue, weakness, dizziness or shortness of breath. Your clinician can check a complete blood count and investigate iron deficiency or other causes when appropriate.
Can thyroid problems cause palpitations while pregnant?
Yes. Excess thyroid hormone activity can cause rapid or forceful heartbeats and may contribute to arrhythmias. Thyroid testing may be appropriate when the history or symptoms suggest thyroid dysfunction.
Should I stop drinking coffee if I have palpitations?
Not everyone with palpitations needs to completely avoid caffeine, but pregnancy guidance generally keeps total caffeine intake below about 200 mg per day. If you consistently notice palpitations after caffeine, reducing your intake further and discussing the symptoms with your clinician may help.
Can a normal ECG rule out an arrhythmia?
Not always. An office ECG records only a short period. If your symptoms occur intermittently, a Holter, patch or event monitor may be needed to record the rhythm while symptoms are actually happening.
Do pregnancy palpitations harm the baby?
Isolated benign palpitations or premature beats in an otherwise healthy pregnancy usually do not imply harm to the fetus. However, significant maternal arrhythmias or underlying cardiovascular disease may require specialist assessment because maternal cardiovascular health can affect pregnancy management.
Related Heart Palpitation Guides
Medical References
- Joglar JA, Kapa S, Saarel EV, et al. 2023 HRS Expert Consensus Statement on the Management of Arrhythmias During Pregnancy. Heart Rhythm. 2023. Heart Rhythm Society consensus statement.
- European Society of Cardiology. 2025 ESC Guidelines for the Management of Cardiovascular Disease and Pregnancy. European Heart Journal. 2025;46(43):4462-4568. ESC guideline.
- American College of Obstetricians and Gynecologists. Urgent Maternal Warning Signs. ACOG patient-safety resources.
- American College of Cardiology. 2023 HRS Guidance on Management of Arrhythmias During Pregnancy: Key Points. ACC summary.
- American College of Obstetricians and Gynecologists. Headaches and Pregnancy. Includes current patient guidance to keep total caffeine intake during pregnancy at no more than 200 mg per day. ACOG.
About the Medical Team
Dr. Albana Greca, MBBS, MMedSc
Family Physician / General Practitioner
Dr. Albana Greca has more than 20 years of experience in primary care, general medicine, chronic disease management, prevention, patient education and digital health.
Dr. Benard Shehu, MBBS, MS
Cardiologist
Dr. Benard Shehu has more than 21 years of cardiovascular experience, including clinical experience relevant to cardiac rhythm disorders and cardiovascular disease.